Page:United States Statutes at Large Volume 102 Part 1.djvu/726

 102 STAT. 688

PUBLIC LAW 100-360—JULY 1, 1988 (B) to care and services furnished on or after January 1, 1989, (C) to premiums for January 1989 and succeeding months, and (D) to blood or blood cells furnished on or after January 1, 1989. (2) ELIMINATION OP POST-HOSPITAL REQUIREMENT FOR EXTENDED

42 USC I395e note.

42 USC 1395WW note.

CARE SERVICES.—The amendments made by this subtitle, insofar as they eliminate the requirement (under section 1812(a)(2) of the Social Security Act) that extended care services are only covered under title XVHI of such Act if they are post-hospital extended care services, shall only apply to extended care services furnished pursuant to an admission to a skilled nursing facility occurring on or after Januai^ 1, 1989. (b) HoLD HARMLESS PROVISIONS.—In the case of an individual for whom a spell of illness (as defined in section 1861(a) of the Social Security Act, as in effect on December 31, 1988) began before January 1, 1989, and had not yet ended as of such date— (1) the amendment made to section 1813(a)(l) of such Act shall not apply to services furnished during that spell of illness during 1989 or 1990, and (2) the amount of any deductible under section 1813(a)(2) of such Act (as amended by this subtitle) shall be reduced during that spell of illness during 1989 or 1990 to the extent the deductible under such section was applied during the spell of illness. (c) ADJUSTMENTS IN PAYMENTS FOR INPATIENT HOSPITAL SERVICES.—

(1) PPS HOSPITALS.—In adjusting DRG prospective payment rates under section 1886(d) of the Social Security Act, outlier cutoff points under section 1886(d)(5)(A) of such Act, and weighting factors under section 1886(d)(4) of such Act for dischaj^es occurring on or after October 1, 1988, the Secretary of Health and Human Services shall, to the extent appropriate, take into consideration the reductions in payments to hospitals by medicare beneficiaries resulting from the elimination of a day limitation on medicare inpatient hospital services (under the amendments made by section 101). (2) PPS-EXEMPT HOSPITAL.—In adjusting target amounts under section 1886(b)(3) of the Social Security Act for cost reporting periods b^pnning on or after October 1, 1988, the Secretary shall, on a hospital-specific basis, take into consideration the reductions in payments to hospitals by medicare beneficiaries resulting from the elimination of a day limitation on medicare inpatient hospital services (under the amendments made by section 101). (d) MISCELLANEOUS CONFORMING AMENDMENTS.—

(1) Section 1811 (42 U.S.C. 1395c) is amended by striking "hospital, related post-hospital" and inserting "inpatient hospital services, extended care services". (2) Section 1814 (42 U.S.C. 13950 is amended— (A) in paragraphs (2)(B) and (6) of subsection (a), by strildng "post-hospital" each place it appears; (B) in subsection (a)(2)(B), by striking ", for any of the conditions" and all that follows up to the semicolon; (C) in subsection (a)(7)(A)— (i) by striking "and" at the end of clause (i),

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